Exchange Traffic

The first state resident completed enrollment through the exchange at 8:04 a.m. -- four minutes after the marketplace's official launch.

By 3 p.m. on Tuesday, Covered California had received:

17,000 calls to its call center; and

Five million page views on its website.

The total number of residents who enrolled in exchange policies is not expected to be known until Nov. 15, according to a Covered California spokesperson.

Details of Challenges

By noon on Tuesday, wait times for calls to the customer service center exceeded 30 minutes.

In addition, the exchange's online home page took several minutes to load later in the day, and continued delays were reported throughout the enrollment process (Sacramento Bee, 10/1).

In a brief statement Tuesday night, exchange officials announced that the site would be taken offline from Tuesday night to Wednesday morning for upgrades that "will help optimize performance for the millions of people expected to log in to use the enrollment function in the future."

Reaction

Some Republican lawmakers cited the delays as evidence that the exchange will not be successful.

Rep. Duncan Hunter (R-Alpine) in a statement said the exchange is "not ready for prime time," adding, "A better system is needed, but even as this law stands, it needs a lot of improvements and alterations that might not be feasible" (Sisson, U-T San Diego, 10/1).

However, Pat Macht -- a spokesperson for Covered California -- noted that the system did not crash on Tuesday, while acknowledging that some consumers experienced delays.

"Like anything when you first start, you've got to adjust a little bit," Macht said, adding, "But people are signing up" (Williams, AP/U-T San Diego, 10/2).

State officials said that the exchange will improve its website and hire more staff to handle the high volume of consumers in the future (Levey, Los Angeles Times, 10/1).

Language, Knowledge Barriers to Enrolling Immigrants in Calif.

Meanwhile, state officials are working to overcome language and knowledge barriers to enrolling immigrants in exchange plans, Kaiser Health News reports.

Reshma Shamasunder -- executive director of the California Immigrant Policy Center -- said there are several barriers to providing immigrants with information about the ACA. For example, such individuals often:

Speak little or no English;

Live in mixed-status families; and

Distrust the government.

In an effort to educate Latinos and other ethnic groups about the law, the state has:

Run advertisements for the exchange in English and Spanish;

Translated information about new health insurance options into Spanish; and

Awarded millions of dollars in grants to groups that work with ethnic groups to help them enroll in exchange plans (Gorman, Kaiser Health News, 10/1).

Problems With Exchanges Across the U.S.

Across the U.S., visitors to the online portals for the federally run and some of the state-operated exchanges experienced technical glitches and heavy traffic that slowed the sites, Reuters reports.

An analysis of at least 47 states revealed frequent error messages or traffic overload notices, particularly for the 36 federally run exchanges (Morgan/Humer, Reuters, 10/1).

For example, visitors to the federally run exchange website -- HealthCare.gov -- at 10 a.m. EDT saw the message: "The system is down at the moment. We're working to resolve the issue as soon as possible. Please try again later" (McKinney, Modern Healthcare, 10/1).

Visitors also faced some localized problems. For example, many consumers in South Texas lack email addresses, which prevented them from signing up online.

Meanwhile, the performance of the online portals for the state-operated exchanges in 16 states and the District of Columbia was mixed. For example:

Hawaii's website did not allow consumers to shop and enroll in coverage until late in the afternoon (Hancock et al., Kaiser Health News, 10/1);

Maryland's website -- Maryland Health Connection -- was down in the morning (Washington Post, 10/1); and

New York's exchange experienced log-in issues within the first two hours of the launch (McKinney, Modern Healthcare, 10/1).

In an interview with NPR, President Obama said, "In the first week, first month, first three months, I would suspect that there will be glitches." He added, "This is 50 states, a lot of people signing up for something. And there are going to be problems" (Jackson, "The Oval," USA Today, 10/1).

Obama reiterated that message in a speech in the Rose Garden on Tuesday, saying, "There have been times this morning where the site's been running more slowly than it normally will." He added, "The reason is because more than one million people visited HealthCare.gov before seven in the morning." He noted that the figure amounts to five times more users than have even been on Medicare's website at one time (Radnofsky, "Washington Wire," Wall Street Journal, 10/1).

For more information on Covered California's launch, check out today's "Capitol Desk."

This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.